Provider Demographics
NPI:1639506389
Name:BUCK-MOYER, LINDSEY
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:
Last Name:BUCK-MOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8690 SIERRA COLLEGE BLVD STE 160-140
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5961
Mailing Address - Country:US
Mailing Address - Phone:916-251-9474
Mailing Address - Fax:
Practice Address - Street 1:5800 STANFORD RANCH RD STE 610
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4387
Practice Address - Country:US
Practice Address - Phone:916-251-9474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CA11488101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)